REQUIRES TWO-THIRDS MAJORITY VOTE (§§ 34-39, 46)

S.B. 130

- *SB130*

SENATE BILL NO. 130–SENATOR WOODHOUSE

FEBRUARY 6, 2019

____________

Referred to Committee on Commerce and Labor SUMMARY—Provides for the licensing and regulation of certain

persons who administer radiation. (BDR 40-61) FISCAL NOTE: Effect on Local Government: Increases or Newly

Provides for Term of Imprisonment in County or City Jail or Detention Facility.

Effect on the State: Yes.

~

EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted.

AN ACT relating to radiation; creating the Radiation Therapy and Radiologic Imaging Advisory Committee; providing for a license to engage in radiation therapy or radiologic imaging; providing for a limited license to engage in radiologic imaging; prescribing the requirements for the issuance and renewal of such a license and limited license; authorizing certain persons to practice as radiologist assistants; prescribing additional qualifications for a person to perform certain types of radiation therapy and radiologic imaging; providing for the enforcement of the requirements concerning radiation therapy and radiologic imaging; authorizing the imposition of disciplinary action or an injunction against a person who engages in radiation therapy or radiologic imaging in certain circumstances; providing penalties; and providing other matters properly relating thereto.

Legislative Counsel’s Digest: Existing law requires the State Board of Health to adopt regulations for the 1 licensing of persons to: (1) receive, possess or transfer radioactive materials and 2 devices; and (2) engage in certain other activities relating to radioactive materials. 3 (NRS 459.201) Section 9 of this bill authorizes the Division of Public and 4 Behavioral Health of the Department of Health and Human Services to suspend, 5 revoke or amend such a license or registration of a person who violates any 6 provision of statute or regulations governing radioactive materials or radiation. 7

– 2 –

- *SB130*

Sections 22-51 of this bill add a new chapter to NRS governing the licensing 8 and regulation of persons who engage in radiation therapy and radiologic imaging. 9 Section 32 of this bill exempts physicians, dentists, chiropractors, podiatrists and 10 persons who administer radiation only to animals, other than humans, from such 11 licensing and regulation. 12 Section 35 of this bill prohibits a person from engaging in: (1) radiologic 13 imaging unless he or she has obtained a license or limited license from the 14 Division; or (2) radiation therapy unless he or she has obtained a license from the 15 Division. Sections 56, 60 and 62 of this bill: (1) authorize a dental hygienist, dental 16 assistant, qualified dental technician, chiropractor’s assistant, participant in certain 17 chiropractic preceptor programs or podiatry hygienist to perform certain types of 18 radiography within the practice of his or her profession if he or she has successfully 19 completed certain training; and (2) prohibit such a person from otherwise engaging 20 in radiation therapy or radiologic imaging. Sections 57, 61 and 63 of this bill make 21 conforming changes. Sections 53-55 and 59 of this bill clarify that a physician 22 assistant, practitioner of respiratory care or homeopathic assistant is prohibited 23 from engaging in radiation therapy or radiologic imaging unless he or she holds a 24 license or limited license. 25 Sections 36 and 37 of this bill prescribe the qualifications for obtaining a 26 license or a limited license. Section 37 also establishes the types of limited licenses 27 that may be issued. Sections 38 and 39 of this bill provide for licensure by 28 endorsement of persons who hold licenses in another state that correspond to a 29 license to engage in radiation therapy and radiologic imaging or a limited license to 30 engage in radiologic imaging. Sections 40 and 50 of this bill provide for the denial 31 or suspension of a license or a limited license if the licensee is delinquent in child 32 support payments, in conformance with federal law. Section 41 of this bill 33 authorizes certain holders of a license to engage in radiation therapy and radiologic 34 imaging to practice as a radiologist assistant. Sections 2 and 65 of this bill 35 authorize the holder of a license to engage in radiation therapy and radiologic 36 imaging or a person training to obtain such a license to take certain actions with 37 regard to drugs to the same extent as was previously authorized for a radiologic or 38 nuclear medicine technician or trainee. Section 3 of this bill makes a conviction of 39 certain crimes involving dangerous drugs grounds for the suspension or revocation 40 of a license to engage in radiation therapy and radiologic imaging. 41 Section 42 of this bill authorizes: (1) an unlicensed person to engage in 42 supervised radiation therapy or radiologic imaging without compensation for the 43 purpose of qualifying for a certification that is a prerequisite for a license or limited 44 license; or (2) a license to practice outside the scope of his or her license under 45 supervision for the purpose of qualifying for a certification that is a prerequisite for 46 being licensed. Section 42 also authorizes the Division to issue a temporary student 47 license, which authorizes an unlicensed person to engage in radiation therapy or 48 radiologic imaging for compensation for the purpose of qualifying for certification 49 that is a prerequisite for being licensed. 50 Sections 44 and 45 of this bill prescribe the required qualifications to perform 51 computed tomography and fluoroscopy, respectively. Section 43 of this bill 52 authorizes a person who is employed performing radiation therapy, radiologic 53 imaging, computed tomography or fluoroscopy to continue to do so without 54 obtaining a license from the Division if he or she registers with the Division and 55 meets certain other requirements. 56 Existing law prohibits a person from operating a radiation machine for 57 mammography unless the person holds a certificate to do so or is a licensed 58 physician or physician assistant. (NRS 457.183) Section 76 of this bill repeals this 59 provision, and section 46 of this bill enacts a similar provision that also requires a 60 person to be licensed to engage in radiation therapy and radiologic imaging before 61 obtaining a certificate. Although section 32 exempts physicians from the 62

– 3 –

- *SB130*

requirement to be licensed and certified before operating a radiation machine for 63 mammography, this exemption does not apply to physician assistants. Therefore, 64 section 46 requires a physician assistant to be licensed to engage in radiation 65 therapy and radiologic imaging and certified to operate a radiation machine for 66 mammography before operating such a machine. Sections 4-7 of this bill make 67 conforming changes. 68 Section 47 of this bill authorizes the Division to: (1) enter and inspect any 69 private or public property for the purpose of enforcing the provisions of this bill 70 governing radiation therapy and radiologic imaging; and (2) request any 71 information necessary to ensure that persons engaged in radiation therapy and 72 radiologic imaging meet applicable requirements. Sections 19 and 47 of this bill 73 provide for the confidentiality of such information and reports of inspections. 74 Section 48 of this bill: (1) prescribes the grounds for disciplinary action against a 75 holder of a license, limited license or certificate; and (2) authorizes a person whose 76 license, limited license or certificate has been revoked to apply to the Division for 77 reinstatement after 2 years. Section 49 of this bill requires the Division to: (1) 78 investigate a complaint filed against a licensee; and (2) provide a licensee against 79 whom disciplinary action may be imposed with the opportunity for a hearing. 80 Section 51 of this bill authorizes the Division to seek an injunction to prevent a 81 violation of provisions of this bill governing the licensing and regulation of persons 82 who engage in radiation therapy or radiologic imaging. Sections 35, 41, 43, 45 and 83 46 make it a misdemeanor to engage in radiation therapy, radiologic imaging or 84 other activity for which a credential is required without the proper credential. 85 Section 33 of this bill creates the Radiation Therapy and Radiologic Imaging 86 Advisory Committee to advise the State Board of Health, the Division and the 87 Legislature concerning radiation therapy and radiologic imaging. Section 34 of this 88 bill requires the Board to adopt certain regulations relating to radiation therapy and 89 radiologic imaging, including regulations defining the scope of practice for 90 radiologist assistants and the holders of licenses and limited licenses. Section 34 91 prohibits the Board from adopting standards of practice more stringent than those 92 adopted by a national professional organization designated by the Division and 93 recommended by the Committee. Section 33 requires the Committee to recommend 94 a national professional organization for that purpose. 95 Existing law requires the Legislative Committee on Health Care to review each 96 regulation that certain licensing entities adopt which relates to standards for the 97 issuance or renewal of a license. (NRS 439B.225) Section 1 of this bill adds to the 98 regulations reviewed by the Committee relating to the standards for the issuance of 99 a license to engage in radiation therapy or radiologic imaging and a limited license 100 to engage in radiologic imaging. 101 Existing law prohibits the Division from issuing or renewing the registration of 102 a radiation machine unless the applicant attests that the radiologic technicians and 103 nuclear medicine technicians employed by the applicant have knowledge of and are 104 in compliance with certain guidelines for the prevention of transmission of 105 infectious agents. (NRS 459.035) Section 8 of this bill deletes those provisions and 106 instead requires the operator of a radiation machine to be properly licensed and in 107 compliance with the provisions of this bill concerning radiation therapy and 108 radiologic imaging. Section 35 requires a person to have knowledge of and be in 109 compliance with those guidelines for the prevention and transmission of infectious 110 agents. 111 Sections 10-18, 20, 52, 58 and 64-72 of this bill make conforming changes to 112 treat holders of licenses and limited licenses similarly to other providers of health 113 care in certain respects. 114

– 4 –

- *SB130*

THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS:

Section 1. NRS 439B.225 is hereby amended to read as 1 follows: 2 439B.225 1. As used in this section, “licensing board” means 3 any division or board empowered to adopt standards for the issuance 4 or renewal of licenses, permits or certificates of registration 5 pursuant to NRS 433.601 to 433.621, inclusive, 435.3305 to 6 435.339, inclusive, chapter 449, 625A, 630, 630A, 631, 632, 633, 7 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640D, 641, 641A, 8 641B, 641C, 652 or 654 of NRS [.] or sections 22 to 51, inclusive, 9 of this act. 10 2. The Committee shall review each regulation that a licensing 11 board proposes or adopts that relates to standards for the issuance or 12 renewal of licenses, permits or certificates of registration issued to a 13 person or facility regulated by the board, giving consideration to: 14 (a) Any oral or written comment made or submitted to it by 15 members of the public or by persons or facilities affected by the 16 regulation; 17 (b) The effect of the regulation on the cost of health care in this 18 State; 19 (c) The effect of the regulation on the number of licensed, 20 permitted or registered persons and facilities available to provide 21 services in this State; and 22 (d) Any other related factor the Committee deems appropriate. 23 3. After reviewing a proposed regulation, the Committee shall 24 notify the agency of the opinion of the Committee regarding the 25 advisability of adopting or revising the proposed regulation. 26 4. The Committee shall recommend to the Legislature as a 27 result of its review of regulations pursuant to this section any 28 appropriate legislation. 29 Sec. 2. NRS 454.213 is hereby amended to read as follows: 30 454.213 1. Except as otherwise provided in NRS 454.217, a 31 drug or medicine referred to in NRS 454.181 to 454.371, inclusive, 32 may be possessed and administered by: 33 (a) A practitioner. 34 (b) A physician assistant licensed pursuant to chapter 630 or 633 35 of NRS, at the direction of his or her supervising physician or a 36 licensed dental hygienist acting in the office of and under the 37 supervision of a dentist. 38 (c) Except as otherwise provided in paragraph (d), a registered 39 nurse licensed to practice professional nursing or licensed practical 40 nurse, at the direction of a prescribing physician, physician assistant 41 licensed pursuant to chapter 630 or 633 of NRS, dentist, podiatric 42

– 5 –

- *SB130*

physician or advanced practice registered nurse, or pursuant to a 1 chart order, for administration to a patient at another location. 2 (d) In accordance with applicable regulations of the Board, a 3 registered nurse licensed to practice professional nursing or licensed 4 practical nurse who is: 5 (1) Employed by a health care agency or health care facility 6 that is authorized to provide emergency care, or to respond to the 7 immediate needs of a patient, in the residence of the patient; and 8 (2) Acting under the direction of the medical director of that 9 agency or facility who works in this State. 10 (e) A medication aide - certified at a designated facility under 11 the supervision of an advanced practice registered nurse or 12 registered nurse and in accordance with standard protocols 13 developed by the State Board of Nursing. As used in this paragraph, 14 “designated facility” has the meaning ascribed to it in 15 NRS 632.0145. 16 (f) Except as otherwise provided in paragraph (g), an advanced 17 emergency medical technician or a paramedic, as authorized by 18 regulation of the State Board of Pharmacy and in accordance with 19 any applicable regulations of: 20 (1) The State Board of Health in a county whose population 21 is less than 100,000; 22 (2) A county board of health in a county whose population is 23 100,000 or more; or 24 (3) A district board of health created pursuant to NRS 25 439.362 or 439.370 in any county. 26 (g) An advanced emergency medical technician or a paramedic 27 who holds an endorsement issued pursuant to NRS 450B.1975, 28 under the direct supervision of a local health officer or a designee of 29 the local health officer pursuant to that section. 30 (h) A respiratory therapist employed in a health care facility. 31 The therapist may possess and administer respiratory products only 32 at the direction of a physician. 33 (i) A dialysis technician, under the direction or supervision of a 34 physician or registered nurse only if the drug or medicine is used for 35 the process of renal dialysis. 36 (j) A medical student or student nurse in the course of his or her 37 studies at an accredited college of medicine or approved school of 38 professional or practical nursing, at the direction of a physician and: 39 (1) In the presence of a physician or a registered nurse; or 40 (2) Under the supervision of a physician or a registered nurse 41 if the student is authorized by the college or school to administer the 42 drug or medicine outside the presence of a physician or nurse. 43 A medical student or student nurse may administer a dangerous 44 drug in the presence or under the supervision of a registered nurse 45

– 6 –

- *SB130*

alone only if the circumstances are such that the registered nurse 1 would be authorized to administer it personally. 2 (k) Any person designated by the head of a correctional 3 institution. 4 (l) An ultimate user or any person designated by the ultimate 5 user pursuant to a written agreement. 6 (m) A [nuclear medicine technologist,] holder of a license to 7 engage in radiation therapy and radiologic imaging issued 8 pursuant to sections 22 to 51, inclusive, of this act, at the direction 9 of a physician and in accordance with any conditions established by 10 regulation of the Board. 11 (n) [A radiologic technologist, at the direction of a physician 12 and in accordance with any conditions established by regulation of 13 the Board. 14 (o)] A chiropractic physician, but only if the drug or medicine is 15 a topical drug used for cooling and stretching external tissue during 16 therapeutic treatments. 17 [(p)] (o) A physical therapist, but only if the drug or medicine is 18 a topical drug which is: 19 (1) Used for cooling and stretching external tissue during 20 therapeutic treatments; and 21 (2) Prescribed by a licensed physician for: 22 (I) Iontophoresis; or 23 (II) The transmission of drugs through the skin using 24 ultrasound. 25 [(q)] (p) In accordance with applicable regulations of the State 26 Board of Health, an employee of a residential facility for groups, as 27 defined in NRS 449.017, pursuant to a written agreement entered 28 into by the ultimate user. 29 [(r)] (q) A veterinary technician or a veterinary assistant at the 30 direction of his or her supervising veterinarian. 31 [(s)] (r) In accordance with applicable regulations of the Board, 32 a registered pharmacist who: 33 (1) Is trained in and certified to carry out standards and 34 practices for immunization programs; 35 (2) Is authorized to administer immunizations pursuant to 36 written protocols from a physician; and 37 (3) Administers immunizations in compliance with the 38 “Standards for Immunization Practices” recommended and 39 approved by the Advisory Committee on Immunization Practices of 40 the Centers for Disease Control and Prevention. 41 [(t)] (s) A registered pharmacist pursuant to written guidelines 42 and protocols developed and approved pursuant to NRS 639.2809 or 43 a collaborative practice agreement, as defined in NRS 639.0052. 44

– 7 –

- *SB130*

[(u)] (t) A person who is enrolled in a training program to 1 become a physician assistant licensed pursuant to chapter 630 or 2 633 of NRS, dental hygienist, advanced emergency medical 3 technician, paramedic, respiratory therapist, dialysis technician, 4 [nuclear medicine technologist, radiologic technologist,] physical 5 therapist or veterinary technician or to obtain a license to engage in 6 radiation therapy and radiologic imaging pursuant to sections 22 7 to 51, inclusive, of this act if the person possesses and administers 8 the drug or medicine in the same manner and under the same 9 conditions that apply, respectively, to a physician assistant licensed 10 pursuant to chapter 630 or 633 of NRS, dental hygienist, advanced 11 emergency medical technician, paramedic, respiratory therapist, 12 dialysis technician, [nuclear medicine technologist, radiologic 13 technologist,] physical therapist , [or] veterinary technician or 14 person licensed to engage in radiation therapy and radiologic 15 imaging who may possess and administer the drug or medicine, and 16 under the direct supervision of a person licensed or registered to 17 perform the respective medical art or a supervisor of such a person. 18 [(v)] (u) A medical assistant, in accordance with applicable 19 regulations of the: 20 (1) Board of Medical Examiners, at the direction of the 21 prescribing physician and under the supervision of a physician or 22 physician assistant. 23 (2) State Board of Osteopathic Medicine, at the direction of 24 the prescribing physician and under the supervision of a physician 25 or physician assistant. 26 2. As used in this section, “accredited college of medicine” has 27 the meaning ascribed to it in NRS 453.375. 28 Sec. 3. NRS 454.361 is hereby amended to read as follows: 29 454.361 A conviction of the violation of any of the provisions 30 of NRS 454.181 to 454.371, inclusive, constitutes grounds for the 31 suspension or revocation of any license issued to such person 32 pursuant to the provisions of chapters 630, 631, 633, 635, 636, 638 33 or 639 of NRS [.] or sections 22 to 51, inclusive, of this act. 34 Sec. 4. NRS 457.065 is hereby amended to read as follows: 35 457.065 The State Board of Health shall adopt regulations for 36 the administration of this chapter which include, without limitation, 37 standards for the [: 38 1. Training and performance of a person who operates a 39 radiation machine for mammography which are at least as stringent 40 as the requirements for accreditation established by the American 41 College of Radiology. 42 2. Inspection] inspection and authorization of a radiation 43 machine for mammography which are at least as stringent as the 44

– 8 –

- *SB130*

requirements for accreditation established by the American College 1 of Radiology. 2 Sec. 5. NRS 457.184 is hereby amended to read as follows: 3 457.184 1. The owner, lessee or other responsible person 4 shall not [operate or] allow to be operated a radiation machine for 5 mammography unless [he or she:] : 6 (a) [Has] The owner, lessee or other responsible person has a 7 valid certificate of authorization from the Division for the machine; 8 and 9 (b) [Is] The machine is accredited by the American College of 10 Radiology or meets the standards established by the State Board of 11 Health pursuant to [subsection 2 of] NRS 457.065. 12 2. To obtain a certificate of authorization from the Division for 13 a radiation machine for mammography, a person must: 14 (a) Submit an application to the Division on a form provided by 15 the Division; 16 (b) Provide any additional information required by the Division; 17 and 18 (c) Pay the fee required by the Division which must be 19 calculated to cover the administrative costs directly related to the 20 process of issuing the certificates. 21 3. After an inspection, the Division shall issue a certificate of 22 authorization for a radiation machine for mammography if the 23 machine: 24 (a) Meets the standards adopted by the State Board of Health 25 pursuant to [subsection 2 of] NRS 457.065; 26 (b) Is specifically designed to perform mammography; and 27 (c) Is used to perform mammography and may be used for 28 screening, diagnostic or therapeutic purposes. 29 4. A certificate of authorization for a radiation machine for 30 mammography expires 1 year after the date on which it was issued 31 unless renewed before that date. The Division may require an 32 inspection of the machine as a prerequisite to renewal of a certificate 33 and shall charge a fee for renewal that is calculated to cover the 34 administrative costs directly related to the process of renewing 35 certificates. 36 5. A person who owns or leases or is otherwise responsible for 37 more than one radiation machine for mammography shall obtain a 38 certificate of authorization for each radiation machine. 39 Sec. 6. NRS 457.185 is hereby amended to read as follows: 40 457.185 1. The Division shall grant or deny an application 41 for [a certificate of authorization to operate a radiation machine for 42 mammography or] a certificate of authorization for a radiation 43 machine for mammography within 4 months after receipt of a 44 complete application. 45

– 9 –

- *SB130*

2. [The Division shall withdraw the certificate of authorization 1 to operate a radiation machine for mammography if it finds that the 2 person violated the provisions of subsection 6 of NRS 457.183. 3 3.] The Division shall deny or withdraw the certificate of 4 authorization of a radiation machine for mammography if it finds 5 that the owner, lessee or other responsible person violated the 6 provisions of subsection 1 of NRS 457.184. 7 [4.] 3. If [a certificate of authorization to operate a radiation 8 machine for mammography or] a certificate of authorization for a 9 radiation machine for mammography is withdrawn, a person must 10 apply for the certificate in the manner provided for an initial 11 certificate. 12 Sec. 7. NRS 457.186 is hereby amended to read as follows: 13 457.186 Upon request, the Division shall hold an 14 administrative hearing concerning the denial or withdrawal of an 15 application for [a certificate of authorization to operate a radiation 16 machine for mammography or] a certificate of authorization for a 17 radiation machine for mammography. 18 Sec. 8. NRS 459.035 is hereby amended to read as follows: 19 459.035 The Division shall not issue or renew the registration 20 of a radiation machine pursuant to regulations adopted by the State 21 Board of Health unless the applicant for issuance or renewal of the 22 registration attests that the [radiologic technologists and nuclear 23 medicine technologists] persons employed by the applicant [have 24 knowledge of and are in compliance with the guidelines of the 25 Centers for Disease Control and Prevention concerning the 26 prevention of transmission of infectious agents through safe and 27 appropriate injection practices.] to operate the radiation machine 28 are properly licensed pursuant to sections 22 to 51, inclusive, of 29 this act. 30 Sec. 9. NRS 459.260 is hereby amended to read as follows: 31 459.260 1. The Division may suspend, revoke or amend a 32 license or registration issued pursuant to NRS 459.201 to a person 33 who has violated any provision of NRS 459.010 to 459.290, 34 inclusive, or any rule, regulation or order issued pursuant thereto. 35 2. In the event of an emergency, the Division may impound, or 36 order the impounding of, sources of ionizing radiation in the 37 possession of any person who is not equipped to observe, or who 38 fails to observe, any provision of NRS 459.010 to 459.290, 39 inclusive, or any rules or regulations issued under NRS 459.010 to 40 459.290, inclusive. 41 Sec. 10. NRS 7.095 is hereby amended to read as follows: 42 7.095 1. An attorney shall not contract for or collect a fee 43 contingent on the amount of recovery for representing a person 44 seeking damages in connection with an action for injury or death 45

– 10 –

- *SB130*

against a provider of health care based upon professional negligence 1 in excess of: 2 (a) Forty percent of the first $50,000 recovered; 3 (b) Thirty-three and one-third percent of the next $50,000 4 recovered; 5 (c) Twenty-five percent of the next $500,000 recovered; and 6 (d) Fifteen percent of the amount of recovery that exceeds 7 $600,000. 8 2. The limitations set forth in subsection 1 apply to all forms of 9 recovery, including, without limitation, settlement, arbitration and 10 judgment. 11 3. For the purposes of this section, “recovered” means the net 12 sum recovered by the plaintiff after deducting any disbursements or 13 costs incurred in connection with the prosecution or settlement of 14 the claim. Costs of medical care incurred by the plaintiff and general 15 and administrative expenses incurred by the office of the attorney 16 are not deductible disbursements or costs. 17 4. As used in this section: 18 (a) “Professional negligence” means a negligent act or omission 19 to act by a provider of health care in the rendering of professional 20 services, which act or omission is the proximate cause of a personal 21 injury or wrongful death. The term does not include services that are 22 outside the scope of services for which the provider of health care is 23 licensed or services for which any restriction has been imposed by 24 the applicable regulatory board or health care facility. 25 (b) “Provider of health care” means a physician licensed under 26 chapter 630 or 633 of NRS, dentist, registered nurse, dispensing 27 optician, optometrist, registered physical therapist, podiatric 28 physician, licensed psychologist, chiropractor, doctor of Oriental 29 medicine, holder of a license or a limited license issued under the 30 provisions of sections 22 to 51, inclusive, of this act, medical 31 laboratory director or technician, licensed dietitian or a licensed 32 hospital and its employees. 33 Sec. 11. NRS 41A.017 is hereby amended to read as follows: 34 41A.017 “Provider of health care” means a physician licensed 35 pursuant to chapter 630 or 633 of NRS, physician assistant, dentist, 36 licensed nurse, dispensing optician, optometrist, registered physical 37 therapist, podiatric physician, licensed psychologist, chiropractor, 38 doctor of Oriental medicine, holder of a license or a limited license 39 issued under the provisions of sections 22 to 51, inclusive, of this 40 act, medical laboratory director or technician, licensed dietitian or a 41 licensed hospital, clinic, surgery center, physicians’ professional 42 corporation or group practice that employs any such person and its 43 employees. 44

– 11 –

- *SB130*

Sec. 12. NRS 42.021 is hereby amended to read as follows: 1 42.021 1. In an action for injury or death against a provider 2 of health care based upon professional negligence, if the defendant 3 so elects, the defendant may introduce evidence of any amount 4 payable as a benefit to the plaintiff as a result of the injury or death 5 pursuant to the United States Social Security Act, any state or 6 federal income disability or worker’s compensation act, any health, 7 sickness or income-disability insurance, accident insurance that 8 provides health benefits or income-disability coverage, and any 9 contract or agreement of any group, organization, partnership or 10 corporation to provide, pay for or reimburse the cost of medical, 11 hospital, dental or other health care services. If the defendant elects 12 to introduce such evidence, the plaintiff may introduce evidence of 13 any amount that the plaintiff has paid or contributed to secure the 14 plaintiff’s right to any insurance benefits concerning which the 15 defendant has introduced evidence. 16 2. A source of collateral benefits introduced pursuant to 17 subsection 1 may not: 18 (a) Recover any amount against the plaintiff; or 19 (b) Be subrogated to the rights of the plaintiff against a 20 defendant. 21 3. In an action for injury or death against a provider of health 22 care based upon professional negligence, a district court shall, at the 23 request of either party, enter a judgment ordering that money 24 damages or its equivalent for future damages of the judgment 25 creditor be paid in whole or in part by periodic payments rather than 26 by a lump-sum payment if the award equals or exceeds $50,000 in 27 future damages. 28 4. In entering a judgment ordering the payment of future 29 damages by periodic payments pursuant to subsection 3, the court 30 shall make a specific finding as to the dollar amount of periodic 31 payments that will compensate the judgment creditor for such future 32 damages. As a condition to authorizing periodic payments of future 33 damages, the court shall require a judgment debtor who is not 34 adequately insured to post security adequate to assure full payment 35 of such damages awarded by the judgment. Upon termination of 36 periodic payments of future damages, the court shall order the return 37 of this security, or so much as remains, to the judgment debtor. 38 5. A judgment ordering the payment of future damages by 39 periodic payments entered pursuant to subsection 3 must specify the 40 recipient or recipients of the payments, the dollar amount of the 41 payments, the interval between payments, and the number of 42 payments or the period of time over which payments will be made. 43 Such payments must only be subject to modification in the event of 44 the death of the judgment creditor. Money damages awarded for loss 45

– 12 –

- *SB130*

of future earnings must not be reduced or payments terminated by 1 reason of the death of the judgment creditor, but must be paid to 2 persons to whom the judgment creditor owed a duty of support, as 3 provided by law, immediately before the judgment creditor’s death. 4 In such cases, the court that rendered the original judgment may, 5 upon petition of any party in interest, modify the judgment to award 6 and apportion the unpaid future damages in accordance with this 7 subsection. 8 6. If the court finds that the judgment debtor has exhibited a 9 continuing pattern of failing to make the periodic payments as 10 specified pursuant to subsection 5, the court shall find the judgment 11 debtor in contempt of court and, in addition to the required periodic 12 payments, shall order the judgment debtor to pay the judgment 13 creditor all damages caused by the failure to make such periodic 14 payments, including, but not limited to, court costs and attorney’s 15 fees. 16 7. Following the occurrence or expiration of all obligations 17 specified in the periodic payment judgment, any obligation of the 18 judgment debtor to make further payments ceases and any security 19 given pursuant to subsection 4 reverts to the judgment debtor. 20 8. As used in this section: 21 (a) “Future damages” includes damages for future medical 22 treatment, care or custody, loss of future earnings, loss of bodily 23 function, or future pain and suffering of the judgment creditor. 24 (b) “Periodic payments” means the payment of money or 25 delivery of other property to the judgment creditor at regular 26 intervals. 27 (c) “Professional negligence” means a negligent act or omission 28 to act by a provider of health care in the rendering of professional 29 services, which act or omission is the proximate cause of a personal 30 injury or wrongful death. The term does not include services that are 31 outside the scope of services for which the provider of health care is 32 licensed or services for which any restriction has been imposed by 33 the applicable regulatory board or health care facility. 34 (d) “Provider of health care” means a physician licensed under 35 chapter 630 or 633 of NRS, dentist, licensed nurse, dispensing 36 optician, optometrist, registered physical therapist, podiatric 37 physician, licensed psychologist, chiropractor, doctor of Oriental 38 medicine, holder of a license or a limited license issued under the 39 provisions of sections 22 to 51, inclusive, of this act, medical 40 laboratory director or technician, licensed dietitian or a licensed 41 hospital and its employees. 42 Sec. 13. NRS 200.471 is hereby amended to read as follows: 43 200.471 1. As used in this section: 44 (a) “Assault” means: 45

– 13 –

- *SB130*

(1) Unlawfully attempting to use physical force against 1 another person; or 2 (2) Intentionally placing another person in reasonable 3 apprehension of immediate bodily harm. 4 (b) “Fire-fighting agency” has the meaning ascribed to it in 5 NRS 239B.020. 6 (c) “Officer” means: 7 (1) A person who possesses some or all of the powers of a 8 peace officer; 9 (2) A person employed in a full-time salaried occupation of 10 fire fighting for the benefit or safety of the public; 11 (3) A member of a volunteer fire department; 12 (4) A jailer, guard or other correctional officer of a city or 13 county jail; 14 (5) A justice of the Supreme Court, judge of the Court of 15 Appeals, district judge, justice of the peace, municipal judge, 16 magistrate, court commissioner, master or referee, including a 17 person acting pro tempore in a capacity listed in this subparagraph; 18 (6) An employee of this State or a political subdivision of 19 this State whose official duties require the employee to make home 20 visits; 21 (7) A civilian employee or a volunteer of a law enforcement 22 agency whose official duties require the employee or volunteer to: 23 (I) Interact with the public; 24 (II) Perform tasks related to law enforcement; and 25 (III) Wear identification, clothing or a uniform that 26 identifies the employee or volunteer as working or volunteering for 27 the law enforcement agency; 28 (8) A civilian employee or a volunteer of a fire-fighting 29 agency whose official duties require the employee or volunteer to: 30 (I) Interact with the public; 31 (II) Perform tasks related to fire fighting or fire 32 prevention; and 33 (III) Wear identification, clothing or a uniform that 34 identifies the employee or volunteer as working or volunteering for 35 the fire-fighting agency; or 36 (9) A civilian employee or volunteer of this State or a 37 political subdivision of this State whose official duties require the 38 employee or volunteer to: 39 (I) Interact with the public; 40 (II) Perform tasks related to code enforcement; and 41 (III) Wear identification, clothing or a uniform that 42 identifies the employee or volunteer as working or volunteering for 43 this State or a political subdivision of this State. 44

– 14 –

- *SB130*

(d) “Provider of health care” means a physician, a medical 1 student, a perfusionist or a physician assistant licensed pursuant to 2 chapter 630 of NRS, a practitioner of respiratory care, a 3 homeopathic physician, an advanced practitioner of homeopathy, a 4 homeopathic assistant, an osteopathic physician, a physician 5 assistant licensed pursuant to chapter 633 of NRS, a podiatric 6 physician, a podiatry hygienist, a physical therapist, a medical 7 laboratory technician, an optometrist, a chiropractor, a 8 chiropractor’s assistant, a doctor of Oriental medicine, a nurse, a 9 student nurse, a certified nursing assistant, a nursing assistant 10 trainee, a medication aide - certified, a dentist, a dental student, a 11 dental hygienist, a dental hygienist student, a pharmacist, a 12 pharmacy student, an intern pharmacist, an attendant on an 13 ambulance or air ambulance, a psychologist, a social worker, a 14 marriage and family therapist, a marriage and family therapist 15 intern, a clinical professional counselor, a clinical professional 16 counselor intern, a licensed dietitian, the holder of a license or a 17 limited license issued under the provisions of sections 22 to 51, 18 inclusive, of this act, an emergency medical technician, an 19 advanced emergency medical technician and a paramedic. 20 (e) “School employee” means a licensed or unlicensed person 21 employed by a board of trustees of a school district pursuant to NRS 22 391.100 or 391.281. 23 (f) “Sporting event” has the meaning ascribed to it in 24 NRS 41.630. 25 (g) “Sports official” has the meaning ascribed to it in 26 NRS 41.630. 27 (h) “Taxicab” has the meaning ascribed to it in NRS 706.8816. 28 (i) “Taxicab driver” means a person who operates a taxicab. 29 (j) “Transit operator” means a person who operates a bus or 30 other vehicle as part of a public mass transportation system. 31 2. A person convicted of an assault shall be punished: 32 (a) If paragraph (c) or (d) does not apply to the circumstances of 33 the crime and the assault is not made with the use of a deadly 34 weapon or the present ability to use a deadly weapon, for a 35 misdemeanor. 36 (b) If the assault is made with the use of a deadly weapon or the 37 present ability to use a deadly weapon, for a category B felony by 38 imprisonment in the state prison for a minimum term of not less 39 than 1 year and a maximum term of not more than 6 years, or by a 40 fine of not more than $5,000, or by both fine and imprisonment. 41 (c) If paragraph (d) does not apply to the circumstances of the 42 crime and if the assault is committed upon an officer, a provider of 43 health care, a school employee, a taxicab driver or a transit operator 44 who is performing his or her duty or upon a sports official based on 45

– 15 –

- *SB130*

the performance of his or her duties at a sporting event and the 1 person charged knew or should have known that the victim was an 2 officer, a provider of health care, a school employee, a taxicab 3 driver, a transit operator or a sports official, for a gross 4 misdemeanor, unless the assault is made with the use of a deadly 5 weapon or the present ability to use a deadly weapon, then for a 6 category B felony by imprisonment in the state prison for a 7 minimum term of not less than 1 year and a maximum term of not 8 more than 6 years, or by a fine of not more than $5,000, or by both 9 fine and imprisonment. 10 (d) If the assault is committed upon an officer, a provider of 11 health care, a school employee, a taxicab driver or a transit operator 12 who is performing his or her duty or upon a sports official based on 13 the performance of his or her duties at a sporting event by a 14 probationer, a prisoner who is in lawful custody or confinement or a 15 parolee, and the probationer, prisoner or parolee charged knew or 16 should have known that the victim was an officer, a provider of 17 health care, a school employee, a taxicab driver, a transit operator or 18 a sports official, for a category D felony as provided in NRS 19 193.130, unless the assault is made with the use of a deadly weapon 20 or the present ability to use a deadly weapon, then for a category B 21 felony by imprisonment in the state prison for a minimum term of 22 not less than 1 year and a maximum term of not more than 6 years, 23 or by a fine of not more than $5,000, or by both fine and 24 imprisonment. 25 Sec. 14. NRS 200.5093 is hereby amended to read as follows: 26 200.5093 1. Any person who is described in subsection 4 and 27 who, in a professional or occupational capacity, knows or has 28 reasonable cause to believe that an older person has been abused, 29 neglected, exploited, isolated or abandoned shall: 30 (a) Except as otherwise provided in subsection 2, report the 31 abuse, neglect, exploitation, isolation or abandonment of the older 32 person to: 33 (1) The local office of the Aging and Disability Services 34 Division of the Department of Health and Human Services; 35 (2) A police department or sheriff’s office; or 36 (3) A toll-free telephone service designated by the Aging and 37 Disability Services Division of the Department of Health and 38 Human Services; and 39 (b) Make such a report as soon as reasonably practicable but not 40 later than 24 hours after the person knows or has reasonable cause to 41 believe that the older person has been abused, neglected, exploited, 42 isolated or abandoned. 43 2. If a person who is required to make a report pursuant to 44 subsection 1 knows or has reasonable cause to believe that the 45

– 16 –

- *SB130*

abuse, neglect, exploitation, isolation or abandonment of the older 1 person involves an act or omission of the Aging and Disability 2 Services Division, another division of the Department of Health and 3 Human Services or a law enforcement agency, the person shall 4 make the report to an agency other than the one alleged to have 5 committed the act or omission. 6 3. Each agency, after reducing a report to writing, shall forward 7 a copy of the report to the Aging and Disability Services Division of 8 the Department of Health and Human Services and the Unit for the 9 Investigation and Prosecution of Crimes. 10 4. A report must be made pursuant to subsection 1 by the 11 following persons: 12 (a) Every physician, dentist, dental hygienist, chiropractor, 13 optometrist, podiatric physician, medical examiner, resident, intern, 14 professional or practical nurse, physician assistant licensed pursuant 15 to chapter 630 or 633 of NRS, perfusionist, psychiatrist, 16 psychologist, marriage and family therapist, clinical professional 17 counselor, clinical alcohol and drug abuse counselor, alcohol and 18 drug abuse counselor, music therapist, athletic trainer, driver of an 19 ambulance, paramedic, licensed dietitian , holder of a license or a 20 limited license issued under the provisions of sections 22 to 51, 21 inclusive, of this act or other person providing medical services 22 licensed or certified to practice in this State, who examines, attends 23 or treats an older person who appears to have been abused, 24 neglected, exploited, isolated or abandoned. 25 (b) Any personnel of a hospital or similar institution engaged in 26 the admission, examination, care or treatment of persons or an 27 administrator, manager or other person in charge of a hospital or 28 similar institution upon notification of the suspected abuse, neglect, 29 exploitation, isolation or abandonment of an older person by a 30 member of the staff of the hospital. 31 (c) A coroner. 32 (d) Every person who maintains or is employed by an agency to 33 provide personal care services in the home. 34 (e) Every person who maintains or is employed by an agency to 35 provide nursing in the home. 36 (f) Every person who operates, who is employed by or who 37 contracts to provide services for an intermediary service 38 organization as defined in NRS 449.4304. 39 (g) Any employee of the Department of Health and Human 40 Services, except the State Long-Term Care Ombudsman appointed 41 pursuant to NRS 427A.125 and any of his or her advocates or 42 volunteers where prohibited from making such a report pursuant to 43 45 C.F.R. § 1321.11. 44

– 17 –

- *SB130*

(h) Any employee of a law enforcement agency or a county’s 1 office for protective services or an adult or juvenile probation 2 officer. 3 (i) Any person who maintains or is employed by a facility or 4 establishment that provides care for older persons. 5 (j) Any person who maintains, is employed by or serves as a 6 volunteer for an agency or service which advises persons regarding 7 the abuse, neglect, exploitation, isolation or abandonment of an 8 older person and refers them to persons and agencies where their 9 requests and needs can be met. 10 (k) Every social worker. 11 (l) Any person who owns or is employed by a funeral home or 12 mortuary. 13 (m) Every person who operates or is employed by a peer support 14 recovery organization, as defined in NRS 449.01563. 15 (n) Every person who operates or is employed by a community 16 health worker pool, as defined in NRS 449.0028, or with whom a 17 community health worker pool contracts to provide the services of a 18 community health worker, as defined in NRS 449.0027. 19 5. A report may be made by any other person. 20 6. If a person who is required to make a report pursuant to 21 subsection 1 knows or has reasonable cause to believe that an older 22 person has died as a result of abuse, neglect, isolation or 23 abandonment, the person shall, as soon as reasonably practicable, 24 report this belief to the appropriate medical examiner or coroner, 25 who shall investigate the cause of death of the older person and 26 submit to the appropriate local law enforcement agencies, the 27 appropriate prosecuting attorney, the Aging and Disability Services 28 Division of the Department of Health and Human Services and the 29 Unit for the Investigation and Prosecution of Crimes his or her 30 written findings. The written findings must include the information 31 required pursuant to the provisions of NRS 200.5094, when 32 possible. 33 7. A division, office or department which receives a report 34 pursuant to this section shall cause the investigation of the report to 35 commence within 3 working days. A copy of the final report of the 36 investigation conducted by a division, office or department, other 37 than the Aging and Disability Services Division of the Department 38 of Health and Human Services, must be forwarded within 30 days 39 after the completion of the report to the: 40 (a) Aging and Disability Services Division; 41 (b) Repository for Information Concerning Crimes Against 42 Older Persons created by NRS 179A.450; and 43 (c) Unit for the Investigation and Prosecution of Crimes. 44

– 18 –

- *SB130*

8. If the investigation of a report results in the belief that an 1 older person is abused, neglected, exploited, isolated or abandoned, 2 the Aging and Disability Services Division of the Department of 3 Health and Human Services or the county’s office for protective 4 services may provide protective services to the older person if the 5 older person is able and willing to accept them. 6 9. A person who knowingly and willfully violates any of the 7 provisions of this section is guilty of a misdemeanor. 8 10. As used in this section, “Unit for the Investigation and 9 Prosecution of Crimes” means the Unit for the Investigation and 10 Prosecution of Crimes Against Older Persons in the Office of the 11 Attorney General created pursuant to NRS 228.265. 12 Sec. 15. NRS 200.50935 is hereby amended to read as 13 follows: 14 200.50935 1. Any person who is described in subsection 3 15 and who, in a professional or occupational capacity, knows or has 16 reasonable cause to believe that a vulnerable person has been 17 abused, neglected, exploited, isolated or abandoned shall: 18 (a) Report the abuse, neglect, exploitation, isolation or 19 abandonment of the vulnerable person to a law enforcement agency; 20 and 21 (b) Make such a report as soon as reasonably practicable but not 22 later than 24 hours after the person knows or has reasonable cause to 23 believe that the vulnerable person has been abused, neglected, 24 exploited, isolated or abandoned. 25 2. If a person who is required to make a report pursuant to 26 subsection 1 knows or has reasonable cause to believe that the 27 abuse, neglect, exploitation, isolation or abandonment of the 28 vulnerable person involves an act or omission of a law enforcement 29 agency, the person shall make the report to a law enforcement 30 agency other than the one alleged to have committed the act or 31 omission. 32 3. A report must be made pursuant to subsection 1 by the 33 following persons: 34 (a) Every physician, dentist, dental hygienist, chiropractor, 35 optometrist, podiatric physician, medical examiner, resident, intern, 36 professional or practical nurse, perfusionist, physician assistant 37 licensed pursuant to chapter 630 or 633 of NRS, psychiatrist, 38 psychologist, marriage and family therapist, clinical professional 39 counselor, clinical alcohol and drug abuse counselor, alcohol and 40 drug abuse counselor, music therapist, athletic trainer, driver of an 41 ambulance, paramedic, licensed dietitian , holder of a license or a 42 limited license issued under the provisions of sections 22 to 51, 43 inclusive, of this act or other person providing medical services 44 licensed or certified to practice in this State, who examines, attends 45

– 19 –

- *SB130*

or treats a vulnerable person who appears to have been abused, 1 neglected, exploited, isolated or abandoned. 2 (b) Any personnel of a hospital or similar institution engaged in 3 the admission, examination, care or treatment of persons or an 4 administrator, manager or other person in charge of a hospital or 5 similar institution upon notification of the suspected abuse, neglect, 6 exploitation, isolation or abandonment of a vulnerable person by a 7 member of the staff of the hospital. 8 (c) A coroner. 9 (d) Every person who maintains or is employed by an agency to 10 provide nursing in the home. 11 (e) Any employee of the Department of Health and Human 12 Services. 13 (f) Any employee of a law enforcement agency or an adult or 14 juvenile probation officer. 15 (g) Any person who maintains or is employed by a facility or 16 establishment that provides care for vulnerable persons. 17 (h) Any person who maintains, is employed by or serves as a 18 volunteer for an agency or service which advises persons regarding 19 the abuse, neglect, exploitation, isolation or abandonment of a 20 vulnerable person and refers them to persons and agencies where 21 their requests and needs can be met. 22 (i) Every social worker. 23 (j) Any person who owns or is employed by a funeral home or 24 mortuary. 25 4. A report may be made by any other person. 26 5. If a person who is required to make a report pursuant to 27 subsection 1 knows or has reasonable cause to believe that a 28 vulnerable person has died as a result of abuse, neglect, isolation or 29 abandonment, the person shall, as soon as reasonably practicable, 30 report this belief to the appropriate medical examiner or coroner, 31 who shall investigate the cause of death of the vulnerable person and 32 submit to the appropriate local law enforcement agencies and the 33 appropriate prosecuting attorney his or her written findings. The 34 written findings must include the information required pursuant to 35 the provisions of NRS 200.5094, when possible. 36 6. A law enforcement agency which receives a report pursuant 37 to this section shall immediately initiate an investigation of the 38 report. 39 7. A person who knowingly and willfully violates any of the 40 provisions of this section is guilty of a misdemeanor. 41 Sec. 16. NRS 200.5095 is hereby amended to read as follows: 42 200.5095 1. Reports made pursuant to NRS 200.5093, 43 200.50935 and 200.5094, and records and investigations relating to 44 those reports, are confidential. 45

– 20 –

- *SB130*

2. A person, law enforcement agency or public or private 1 agency, institution or facility who willfully releases data or 2 information concerning the reports and investigation of the abuse, 3 neglect, exploitation, isolation or abandonment of older persons or 4 vulnerable persons, except: 5 (a) Pursuant to a criminal prosecution; 6 (b) Pursuant to NRS 200.50982; or 7 (c) To persons or agencies enumerated in subsection 3, 8 is guilty of a misdemeanor. 9 3. Except as otherwise provided in subsection 2 and NRS 10 200.50982, data or information concerning the reports and 11 investigations of the abuse, neglect, exploitation, isolation or 12 abandonment of an older person or a vulnerable person is available 13 only to: 14 (a) A physician who is providing care to an older person or a 15 vulnerable person who may have been abused, neglected, exploited, 16 isolated or abandoned; 17 (b) An agency responsible for or authorized to undertake the 18 care, treatment and supervision of the older person or vulnerable 19 person; 20 (c) A district attorney or other law enforcement official who 21 requires the information in connection with an investigation of the 22 abuse, neglect, exploitation, isolation or abandonment of the older 23 person or vulnerable person; 24 (d) A court which has determined, in camera, that public 25 disclosure of such information is necessary for the determination of 26 an issue before it; 27 (e) A person engaged in bona fide research, but the identity of 28 the subjects of the report must remain confidential; 29 (f) A grand jury upon its determination that access to such 30 records is necessary in the conduct of its official business; 31 (g) Any comparable authorized person or agency in another 32 jurisdiction; 33 (h) A legal guardian of the older person or vulnerable person, if 34 the identity of the person who was responsible for reporting the 35 alleged abuse, neglect, exploitation, isolation or abandonment of the 36 older person or vulnerable person to the public agency is protected, 37 and the legal guardian of the older person or vulnerable person is 38 not the person suspected of such abuse, neglect, exploitation, 39 isolation or abandonment; 40 (i) If the older person or vulnerable person is deceased, the 41 executor or administrator of his or her estate, if the identity of the 42 person who was responsible for reporting the alleged abuse, neglect, 43 exploitation, isolation or abandonment of the older person or 44 vulnerable person to the public agency is protected, and the executor 45

– 21 –

- *SB130*

or administrator is not the person suspected of such abuse, neglect, 1 exploitation, isolation or abandonment; or 2 (j) The older person or vulnerable person named in the report as 3 allegedly being abused, neglected, exploited, isolated or abandoned, 4 if that person is not legally incompetent. 5 4. If the person who is reported to have abused, neglected, 6 exploited, isolated or abandoned an older person or a vulnerable 7 person is the holder of a license or certificate issued pursuant to 8 chapters 449, 630 to 641B, inclusive, or 654 of NRS, or sections 22 9 to 51, inclusive, of this act, the information contained in the report 10 must be submitted to the board that issued the license. 11 5. If data or information concerning the reports and 12 investigations of the abuse, neglect, exploitation, isolation or 13 abandonment of an older person or a vulnerable person is made 14 available pursuant to paragraph (b) or (j) of subsection 3 or 15 subsection 4, the name and any other identifying information of the 16 person who made the report must be redacted before the data or 17 information is made available. 18 Sec. 17. NRS 200.810 is hereby amended to read as follows: 19 200.810 “Health care procedure” means any medical 20 procedure, other than a surgical procedure, that requires a license to 21 perform pursuant to chapters 630 to 637, inclusive, 639 or 640 of 22 NRS [.] or sections 22 to 51, inclusive, of this act. 23 Sec. 18. NRS 200.820 is hereby amended to read as follows: 24 200.820 “Surgical procedure” means any invasive medical 25 procedure where a break in the skin is created and there is contact 26 with the mucosa or any minimally invasive medical procedure 27 where a break in the skin is created or which involves manipulation 28 of the internal body cavity beyond a natural or artificial body orifice 29 which requires a license to perform pursuant to chapters 630 to 637, 30 inclusive, 639 or 640 of NRS [.] or sections 22 to 51, inclusive, of 31 this act. 32 Sec. 19. NRS 239.010 is hereby amended to read as follows: 33 239.010 1. Except as otherwise provided in this section and 34 NRS 1.4683, 1.4687, 1A.110, 3.2203, 41.071, 49.095, 49.293, 35 62D.420, 62D.440, 62E.516, 62E.620, 62H.025, 62H.030, 62H.170, 36 62H.220, 62H.320, 75A.100, 75A.150, 76.160, 78.152, 80.113, 37 81.850, 82.183, 86.246, 86.54615, 87.515, 87.5413, 87A.200, 38 87A.580, 87A.640, 88.3355, 88.5927, 88.6067, 88A.345, 88A.7345, 39 89.045, 89.251, 90.730, 91.160, 116.757, 116A.270, 116B.880, 40 118B.026, 119.260, 119.265, 119.267, 119.280, 119A.280, 41 119A.653, 119B.370, 119B.382, 120A.690, 125.130, 125B.140, 42 126.141, 126.161, 126.163, 126.730, 127.007, 127.057, 127.130, 43 127.140, 127.2817, 128.090, 130.312, 130.712, 136.050, 159.044, 44 159A.044, 172.075, 172.245, 176.01249, 176.015, 176.0625, 45

– 22 –

- *SB130*

176.09129, 176.156, 176A.630, 178.39801, 178.4715, 178.5691, 1 179.495, 179A.070, 179A.165, 179D.160, 200.3771, 200.3772, 2 200.5095, 200.604, 202.3662, 205.4651, 209.392, 209.3925, 3 209.419, 209.521, 211A.140, 213.010, 213.040, 213.095, 213.131, 4 217.105, 217.110, 217.464, 217.475, 218A.350, 218E.625, 5 218F.150, 218G.130, 218G.240, 218G.350, 228.270, 228.450, 6 228.495, 228.570, 231.069, 231.1473, 233.190, 237.300, 239.0105, 7 239.0113, 239B.030, 239B.040, 239B.050, 239C.140, 239C.210, 8 239C.230, 239C.250, 239C.270, 240.007, 241.020, 241.030, 9 241.039, 242.105, 244.264, 244.335, 247.540, 247.550, 247.560, 10 250.087, 250.130, 250.140, 250.150, 268.095, 268.490, 268.910, 11 271A.105, 281.195, 281.805, 281A.350, 281A.680, 281A.685, 12 281A.750, 281A.755, 281A.780, 284.4068, 286.110, 287.0438, 13 289.025, 289.080, 289.387, 289.830, 293.4855, 293.5002, 293.503, 14 293.504, 293.558, 293.906, 293.908, 293.910, 293B.135, 293D.510, 15 331.110, 332.061, 332.351, 333.333, 333.335, 338.070, 338.1379, 16 338.1593, 338.1725, 338.1727, 348.420, 349.597, 349.775, 353.205, 17 353A.049, 353A.085, 353A.100, 353C.240, 360.240, 360.247, 18 360.255, 360.755, 361.044, 361.610, 365.138, 366.160, 368A.180, 19 370.257, 370.327, 372A.080, 378.290, 378.300, 379.008, 379.1495, 20 385A.830, 385B.100, 387.626, 387.631, 388.1455, 388.259, 21 388.501, 388.503, 388.513, 388.750, 388A.247, 388A.249, 391.035, 22 391.120, 391.925, 392.029, 392.147, 392.264, 392.271, 392.315, 23 392.317, 392.325, 392.327, 392.335, 392.850, 394.167, 394.1698, 24 394.447, 394.460, 394.465, 396.3295, 396.405, 396.525, 396.535, 25 396.9685, 398A.115, 408.3885, 408.3886, 408.3888, 408.5484, 26 412.153, 416.070, 422.2749, 422.305, 422A.342, 422A.350, 27 425.400, 427A.1236, 427A.872, 432.028, 432.205, 432B.175, 28 432B.280, 432B.290, 432B.407, 432B.430, 432B.560, 432B.5902, 29 433.534, 433A.360, 437.145, 439.840, 439B.420, 440.170, 30 441A.195, 441A.220, 441A.230, 442.330, 442.395, 442.735, 31 445A.665, 445B.570, 449.209, 449.245, 449A.112, 450.140, 32 453.164, 453.720, 453A.610, 453A.700, 458.055, 458.280, 459.050, 33 459.3866, 459.555, 459.7056, 459.846, 463.120, 463.15993, 34 463.240, 463.3403, 463.3407, 463.790, 467.1005, 480.365, 480.940, 35 481.063, 481.091, 481.093, 482.170, 482.5536, 483.340, 483.363, 36 483.575, 483.659, 483.800, 484E.070, 485.316, 501.344, 503.452, 37 522.040, 534A.031, 561.285, 571.160, 584.655, 587.877, 598.0964, 38 598.098, 598A.110, 599B.090, 603.070, 603A.210, 604A.710, 39 612.265, 616B.012, 616B.015, 616B.315, 616B.350, 618.341, 40 618.425, 622.310, 623.131, 623A.137, 624.110, 624.265, 624.327, 41 625.425, 625A.185, 628.418, 628B.230, 628B.760, 629.047, 42 629.069, 630.133, 630.30665, 630.336, 630A.555, 631.368, 43 632.121, 632.125, 632.405, 633.283, 633.301, 633.524, 634.055, 44 634.214, 634A.185, 635.158, 636.107, 637.085, 637B.288, 638.087, 45

– 23 –

- *SB130*

638.089, 639.2485, 639.570, 640.075, 640A.220, 640B.730, 1 640C.400, 640C.600, 640C.620, 640C.745, 640C.760, 640D.190, 2 640E.340, 641.090, 641.325, 641A.191, 641A.289, 641B.170, 3 641B.460, 641C.760, 641C.800, 642.524, 643.189, 644A.870, 4 645.180, 645.625, 645A.050, 645A.082, 645B.060, 645B.092, 5 645C.220, 645C.225, 645D.130, 645D.135, 645E.300, 645E.375, 6 645G.510, 645H.320, 645H.330, 647.0945, 647.0947, 648.033, 7 648.197, 649.065, 649.067, 652.228, 654.110, 656.105, 661.115, 8 665.130, 665.133, 669.275, 669.285, 669A.310, 671.170, 673.450, 9 673.480, 675.380, 676A.340, 676A.370, 677.243, 679B.122, 10 679B.152, 679B.159, 679B.190, 679B.285, 679B.690, 680A.270, 11 681A.440, 681B.260, 681B.410, 681B.540, 683A.0873, 685A.077, 12 686A.289, 686B.170, 686C.306, 687A.110, 687A.115, 687C.010, 13 688C.230, 688C.480, 688C.490, 689A.696, 692A.117, 692C.190, 14 692C.3507, 692C.3536, 692C.3538, 692C.354, 692C.420, 15 693A.480, 693A.615, 696B.550, 696C.120, 703.196, 704B.320, 16 704B.325, 706.1725, 706A.230, 710.159, 711.600, and section 47 17 of this act, sections 35, 38 and 41 of chapter 478, Statutes of 18 Nevada 2011 and section 2 of chapter 391, Statutes of Nevada 2013 19 and unless otherwise declared by law to be confidential, all public 20 books and public records of a governmental entity must be open at 21 all times during office hours to inspection by any person, and may 22 be fully copied or an abstract or memorandum may be prepared 23 from those public books and public records. Any such copies, 24 abstracts or memoranda may be used to supply the general public 25 with copies, abstracts or memoranda of the records or may be used 26 in any other way to the advantage of the governmental entity or of 27 the general public. This section does not supersede or in any manner 28 affect the federal laws governing copyrights or enlarge, diminish or 29 affect in any other manner the rights of a person in any written book 30 or record which is copyrighted pursuant to federal law. 31 2. A governmental entity may not reject a book or record 32 which is copyrighted solely because it is copyrighted. 33 3. A governmental entity that has legal custody or control of a 34 public book or record shall not deny a request made pursuant to 35 subsection 1 to inspect or copy or receive a copy of a public book or 36 record on the basis that the requested public book or record contains 37 information that is confidential if the governmental entity can 38 redact, delete, conceal or separate the confidential information from 39 the information included in the public book or record that is not 40 otherwise confidential. 41 4. A person may request a copy of a public record in any 42 medium in which the public record is readily available. An officer, 43 employee or agent of a governmental entity who has legal custody 44 or control of a public record: 45

– 24 –

- *SB130*

(a) Shall not refuse to provide a copy of that public record in a 1 readily available medium because the officer, employee or agent has 2 already prepared or would prefer to provide the copy in a different 3 medium. 4 (b) Except as otherwise provided in NRS 239.030, shall, upon 5 request, prepare the copy of the public record and shall not require 6 the person who has requested the copy to prepare the copy himself 7 or herself. 8 Sec. 20. NRS 432B.220 is hereby amended to read as follows: 9 432B.220 1. Any person who is described in subsection 4 10 and who, in his or her professional or occupational capacity, knows 11 or has reasonable cause to believe that a child has been abused or 12 neglected shall: 13 (a) Except as otherwise provided in subsection 2, report the 14 abuse or neglect of the child to an agency which provides child 15 welfare services or to a law enforcement agency; and 16 (b) Make such a report as soon as reasonably practicable but not 17 later than 24 hours after the person knows or has reasonable cause to 18 believe that the child has been abused or neglected. 19 2. If a person who is required to make a report pursuant to 20 subsection 1 knows or has reasonable cause to believe that the abuse 21 or neglect of the child involves an act or omission of: 22 (a) A person directly responsible or serving as a volunteer for or 23 an employee of a public or private home, institution or facility 24 where the child is receiving child care outside of the home for a 25 portion of the day, the person shall make the report to a law 26 enforcement agency. 27 (b) An agency which provides child welfare services or a law 28 enforcement agency, the person shall make the report to an agency 29 other than the one alleged to have committed the act or omission, 30 and the investigation of the abuse or neglect of the child must be 31 made by an agency other than the one alleged to have committed the 32 act or omission. 33 3. Any person who is described in paragraph (a) of subsection 34 4 who delivers or provides medical services to a newborn infant and 35 who, in his or her professional or occupational capacity, knows or 36 has reasonable cause to believe that the newborn infant has been 37 affected by a fetal alcohol spectrum disorder or prenatal substance 38 abuse or has withdrawal symptoms resulting from prenatal drug 39 exposure shall, as soon as reasonably practicable but not later than 40 24 hours after the person knows or has reasonable cause to believe 41 that the newborn infant is so affected or has such symptoms, notify 42 an agency which provides child welfare services of the condition of 43 the infant and refer each person who is responsible for the welfare 44 of the infant to an agency which provides child welfare services for 45

– 25 –

- *SB130*

appropriate counseling, training or other services. A notification and 1 referral to an agency which provides child welfare services pursuant 2 to this subsection shall not be construed to require prosecution for 3 any illegal action. 4 4. A report must be made pursuant to subsection 1 by the 5 following persons: 6 (a) A person providing services licensed or certified in this State 7 pursuant to, without limitation, chapter 450B, 630, 630A, 631, 632, 8 633, 634, 634A, 635, 636, 637, 637B, 639, 640, 640A, 640B, 640C, 9 640D, 640E, 641, 641A, 641B or 641C of NRS [.] or sections 22 to 10 51, inclusive, of this act. 11 (b) Any personnel of a medical facility licensed pursuant to 12 chapter 449 of NRS who are engaged in the admission, examination, 13 care or treatment of persons or an administrator, manager or other 14 person in charge of such a medical facility upon notification of 15 suspected abuse or neglect of a child by a member of the staff of the 16 medical facility. 17 (c) A coroner. 18 (d) A member of the clergy, practitioner of Christian Science or 19 religious healer, unless the person has acquired the knowledge of the 20 abuse or neglect from the offender during a confession. 21 (e) A person employed by a public school or private school and 22 any person who serves as a volunteer at such a school. 23 (f) Any person who maintains or is employed by a facility or 24 establishment that provides care for children, children’s camp or 25 other public or private facility, institution or agency furnishing care 26 to a child. 27 (g) Any person licensed pursuant to chapter 424 of NRS to 28 conduct a foster home. 29 (h) Any officer or employee of a law enforcement agency or an 30 adult or juvenile probation officer. 31 (i) Except as otherwise provided in NRS 432B.225, an attorney. 32 (j) Any person who maintains, is employed by or serves as a 33 volunteer for an agency or service which advises persons regarding 34 abuse or neglect of a child and refers them to persons and agencies 35 where their requests and needs can be met. 36 (k) Any person who is employed by or serves as a volunteer for 37 a youth shelter. As used in this paragraph, “youth shelter” has the 38 meaning ascribed to it in NRS 244.427. 39 (l) Any adult person who is employed by an entity that provides 40 organized activities for children, including, without limitation, a 41 person who is employed by a school district or public school. 42 5. A report may be made by any other person. 43 6. If a person who is required to make a report pursuant to 44 subsection 1 knows or has reasonable cause to believe that a child 45

– 26 –

- *SB130*

has died as a result of abuse or neglect, the person shall, as soon as 1 reasonably practicable, report this belief to an agency which 2 provides child welfare services or a law enforcement agency. If such 3 a report is made to a law enforcement agency, the law enforcement 4 agency shall notify an agency which provides child welfare services 5 and the appropriate medical examiner or coroner of the report. If 6 such a report is made to an agency which provides child welfare 7 services, the agency which provides child welfare services shall 8 notify the appropriate medical examiner or coroner of the report. 9 The medical examiner or coroner who is notified of a report 10 pursuant to this subsection shall investigate the report and submit 11 his or her written findings to the appropriate agency which provides 12 child welfare services, the appropriate district attorney and a law 13 enforcement agency. The written findings must include, if 14 obtainable, the information required pursuant to the provisions of 15 subsection 2 of NRS 432B.230. 16 7. The agency, board, bureau, commission, department, 17 division or political subdivision of the State responsible for the 18 licensure, certification or endorsement of a person who is described 19 in subsection 4 and who is required in his or her professional or 20 occupational capacity to be licensed, certified or endorsed in this 21 State shall, at the time of initial licensure, certification or 22 endorsement: 23 (a) Inform the person, in writing or by electronic 24 communication, of his or her duty as a mandatory reporter pursuant 25 to this section; 26 (b) Obtain a written acknowledgment or electronic record from 27 the person that he or she has been informed of his or her duty 28 pursuant to this section; and 29 (c) Maintain a copy of the written acknowledgment or electronic 30 record for as long as the person is licensed, certified or endorsed in 31 this State. 32 8. The employer of a person who is described in subsection 4 33 and who is not required in his or her professional or occupational 34 capacity to be licensed, certified or endorsed in this State must, upon 35 initial employment of the person: 36 (a) Inform the person, in writing or by electronic 37 communication, of his or her duty as a mandatory reporter pursuant 38 to this section; 39 (b) Obtain a written acknowledgment or electronic record from 40 the person that he or she has been informed of his or her duty 41 pursuant to this section; and 42 (c) Maintain a copy of the written acknowledgment or electronic 43 record for as long as the person is employed by the employer. 44

– 27 –

- *SB130*

9. Before a person may serve as a volunteer at a public school 1 or private school, the school must: 2 (a) Inform the person, in writing or by electronic 3 communication, of his or her duty as a mandatory reporter pursuant 4 to this section and NRS 392.303; 5 (b) Obtain a written acknowledgment or electronic record from 6 the person that he or she has been informed of his or her duty 7 pursuant to this section and NRS 392.303; and 8 (c) Maintain a copy of the written acknowledgment or electronic 9 record for as long as the person serves as a volunteer at the school. 10 10. As used in this section: 11 (a) “Private school” has the meaning ascribed to it in 12 NRS 394.103. 13 (b) “Public school” has the meaning ascribed to it in 14 NRS 385.007. 15 Sec. 21. Title 54 of NRS is hereby amended by adding thereto 16 a new chapter to consist of the provisions set forth as sections 22 to 17 51, inclusive, of this act. 18 Sec. 22. As used in this chapter, unless the context otherwise 19 requires, the words and terms defined in sections 23 to 31, 20 inclusive, of this act have the meanings ascribed to them in those 21 sections. 22 Sec. 23. “Board” means the State Board of Health. 23 Sec. 24. “Certificate” means a certificate of authorization to 24 operate a radiation machine for mammography issued pursuant to 25 section 46 of this act. 26 Sec. 25. “Division” means the Division of Public and 27 Behavioral Health of the Department of Health and Human 28 Services. 29 Sec. 26. “License” means a license to engage in radiation 30 therapy and radiologic imaging issued pursuant to section 36, 38 31 or 39 of this act. The term does not include a limited license. 32 Sec. 27. “Limited license” means a limited license to engage 33 in radiologic imaging issued pursuant to section 37, 38 or 39 of 34 this act. 35 Sec. 28. “Mammography” has the meaning ascribed to it in 36 NRS 457.182. 37 Sec. 29. “Radiation therapy” means the administration of 38 ionizing radiation for therapeutic purposes. 39 Sec. 30. “Radiologic imaging” means the use of ionizing 40 radiation to diagnose or visualize a medical condition. 41 Sec. 31. “Radiologist assistant” means a person who holds a 42 license and meets the requirements of section 41 of this act. 43 Sec. 32. The provisions of this chapter do not apply to: 44

– 28 –

- *SB130*

1. A physician licensed pursuant to chapter 630 or 633 of 1 NRS. 2 2. A dentist licensed pursuant to chapter 631 of NRS. 3 3. A chiropractic physician licensed pursuant to chapter 634 4 of NRS. 5 4. A podiatric physician licensed pursuant to chapter 635 of 6 NRS. 7 5. The administration of radiation to nonhuman animals for 8 any purpose, including, without limitation, therapy or imaging. 9 Sec. 33. 1. The Radiation Therapy and Radiologic Imaging 10 Advisory Committee is hereby created. 11 2. The Committee consists of seven members, all of whom are 12 voting members, appointed by the Governor. The Governor shall 13 ensure that the members of the Committee represent the 14 geographic diversity of this State. The Governor shall appoint to 15 the Committee: 16 (a) One member who holds a license and is certified by the 17 American Registry of Radiologic Technologists, or its successor 18 organization, to practice in the area of radiography. 19 (b) One member who holds a license and is certified by the 20 American Registry of Radiologic Technologists, or its successor 21 organization, to practice in the area of nuclear medicine 22 technology. 23 (c) One member who holds a license and is certified by the 24 American Registry of Radiologic Technologists, or its successor 25 organization, to practice in the area of radiation therapy. 26 (d) One member who holds a limited license. 27 (e) One member who is a physician specializing in radiology. 28 (f) One member who is a physician specializing in an area 29 other than radiology, or a dentist, chiropractor or podiatrist. 30 (g) One member who is a person responsible for administering 31 radiation therapy in a medical facility or office who is certified to 32 provide clinical professional services in a field of medical physics. 33 3. After the initial terms, the members of the Committee serve 34 terms of 3 years. A vacancy on the Committee must be filled in the 35 same manner as the initial appointment. No member may serve 36 more than two consecutive terms. 37 4. Members of the Committee serve without compensation, 38 except that each member of the Committee is entitled to receive the 39 per diem allowance and travel expenses provided for state officers 40 and employees generally. 41 5. The Committee shall annually select a Chair from among 42 the members appointed pursuant to paragraphs (a) to (d), 43 inclusive, of subsection 2, and a Vice Chair from among its 44 members. 45

– 29 –

- *SB130*

6. The Committee shall meet at least once each year and such 1 other times as requested by the Administrator of the Division. The 2 Committee may meet by telephone, videoconference or other 3 electronic means in accordance with the provisions of chapter 241 4 of NRS. The Administrator shall prescribe the agenda for each 5 meeting. The Committee may submit items to the Administrator to 6 consider for inclusion on the agenda for a meeting. 7 7. The Committee shall: 8 (a) Recommend to the Board a national professional 9 organization against which the scope of practice will be measured 10 pursuant to paragraph (b) of subsection 1 of section 34 of this act; 11 and 12 (b) Make such other recommendations to the Board, the 13 Division and the Legislature concerning radiation therapy and 14 radiologic imaging as it deems proper. 15 Sec. 34. 1. The Board shall adopt regulations: 16 (a) Establishing the fees for the application for and the 17 issuance and renewal of a license or limited license. 18 (b) Defining the scope of practice for radiologist assistants and 19 persons who hold licenses and limited licenses. Such regulations 20 must be at least as stringent as the scope of practice adopted by a 21 national professional organization whose membership consists of 22 persons licensed or certified to engage in radiation therapy or 23 radiologic imaging. The national professional organization must 24 be designated by the Board upon the recommendation of the 25 Radiation Therapy and Radiologic Imaging Advisory Committee 26 pursuant to subsection 7 of section 33 of this act. 27 (c) Prescribing the requirements for continuing education for 28 the renewal of a license or limited license. Such regulations must 29 require the holder of a license to complete more hours of 30 continuing education than the holder of a limited license. 31 (d) Prescribing the qualifications of a person who is 32 authorized to supervise the holder of a limited license, the tasks for 33 which such supervision is required and the level of supervision 34 required. 35 (e) Defining the terms “crime involving moral turpitude” and 36 “unprofessional conduct” for the purposes of section 48 of this 37 act. 38 (f) Establishing standards for the training and performance of 39 a person who holds a certificate. Such standards must be at least 40 as stringent as the requirements for accreditation established by 41 the American College of Radiology or its successor organization. 42 2. The Board may adopt any other regulations necessary or 43 convenient to carry out the provisions of this chapter. 44

– 30 –

- *SB130*

3. At the same time that the Board provides notice pursuant 1 to chapter 233B of NRS or NRS 241.020 of any meeting or 2 workshop relating to the adoption of a proposed regulation 3 pursuant to this chapter, the Board shall submit an electronic copy 4 of the notice to the Radiation Therapy and Radiologic Imaging 5 Advisory Committee created by section 33 of this act. 6 4. All money received from fees and penalties pursuant to the 7 provisions of this chapter must be forwarded to the State 8 Treasurer for credit to the Fund for the Care of Sites for the 9 Disposal of Radioactive Waste created by NRS 459.231. 10 5. The Division shall enforce the provisions of this chapter. 11 Sec. 35. 1. Except as otherwise provided in sections 42, 43, 12 56, 60 and 62 of this act, a person shall not engage in: 13 (a) Radiologic imaging unless he or she has obtained a license 14 or limited license from the Division. 15 (b) Radiation therapy unless he or she has obtained a license 16 from the Division. 17 (c) Radiation therapy or radiologic imaging which is outside 18 the scope of practice authorized for his or her license or limited 19 license by the regulations adopted pursuant to section 34 of this 20 act. 21 2. A person who wishes to obtain or renew a license or 22 limited license must apply to the Division in the form prescribed by 23 the Division. 24 3. A license or limited license expires 2 years after the date on 25 which the license was issued and must be renewed on or before 26 that date. 27 4. The Division shall not issue or renew a license or limited 28 license unless the applicant for issuance or renewal of the license 29 or limited license attests to knowledge of and compliance with the 30 guidelines of the Centers for Disease Control and Prevention 31 concerning the prevention of transmission of infectious agents 32 through safe and appropriate injection practices. 33 5. A provisional license or provisional limited license may not 34 be renewed and expires: 35 (a) On the date on which the holder of the provisional license 36 or provisional limited license is issued a license or limited license 37 by the Division; 38 (b) On the date on which the application of the holder of the 39 provisional license or provisional limited license for a license or 40 limited license is denied by the Division; or 41 (c) One year after the date on which the holder of the 42 provisional license or provisional limited license is initially 43 employed to engage in radiation therapy or radiologic imaging. 44

– 31 –

- *SB130*

6. A person who engages in radiation therapy or radiologic 1 imaging in violation of the provisions of this section is guilty of a 2 misdemeanor. 3 Sec. 36. The Division may issue a license to engage in 4 radiation therapy and radiologic imaging to a person who: 5 1. Has successfully completed an educational program 6 accredited by the Joint Review Committee on Education in 7 Radiologic Technology, or its successor organization, the Joint 8 Review Committee on Educational Programs in Nuclear Medicine 9 Technology, or its successor organization, or another national 10 accrediting organization approved by the Division; and 11 2. Is certified by the American Registry of Radiologic 12 Technologists, or its successor organization, to practice in the area 13 of radiography, nuclear medicine technology or radiation therapy 14 or the Nuclear Medicine Technology Certification Board, or its 15 successor organization, in nuclear medicine or meets any 16 alternative standards prescribed by regulation of the Board. 17 Sec. 37. 1. The Division may issue a limited license to 18 engage in radiologic imaging to a person who has completed a 19 course of study in limited X-ray machine operation that 20 incorporates the Limited X-Ray Machine Operator Curriculum 21 prescribed by the American Society of Radiologic Technologists, 22 or its successor organization, and satisfies the provisions of 23 subsection 2. 24 2. A person may obtain a limited license only if the person: 25 (a) Has passed an examination for the limited scope of 26 practice in radiography administered by the American Registry of 27 Radiologic Technologists or its successor organization; 28 (b) If applying for a limited license in spine and extremity 29 radiography, is certified by the American Chiropractic Registry of 30 Radiologic Technologists or its successor organization; 31 (c) If applying for a limited license in podiatric radiography, is 32 licensed as a podiatry hygienist pursuant to NRS 635.093 or 33 certified by the American Society of Podiatric Medical Assistants 34 or its successor organization; or 35 (d) If applying for a limited license in bone densitometry, is 36 certified as a bone densitometry technologist or a certified 37 densitometry technologist by the International Society for Clinical 38 Densitometry, or its successor organization, or has successfully 39 completed the examination for bone densitometry equipment 40 operators administered by the American Registry of Radiologic 41 Technologists or its successor organization. 42 3. The holder of a limited license may perform radiologic 43 imaging only within the scope of the limited license, as described 44 in this subsection and the regulations adopted pursuant to 45

– 32 –

- *SB130*

section 34 of this act, and under the supervision required by those 1 regulations. The Division may issue a limited license in: 2 (a) Chest radiography, which authorizes the holder of the 3 limited license to engage in radiography of the thorax, heart and 4 lungs; 5 (b) Extremities radiography, which authorizes the holder of 6 the limited license to engage in radiography of the upper and 7 lower extremities, including the pelvic girdle; 8 (c) Spine and extremity radiography, which authorizes the 9 holder of the limited license to engage in radiography of the 10 vertebral column and the upper and lower extremities, including 11 the pelvic girdle; 12 (d) Skull and sinus radiography, which authorizes the holder 13 of the limited license to engage in radiography of the skull and 14 face; 15 (e) Podiatric radiography, which authorizes the holder of the 16 limited license to engage in radiography of the foot, ankle and 17 lower leg below the knee; 18 (f) Bone densitometry, which authorizes the holder of the 19 limited license to engage in the determination of bone mass by 20 measuring the absorption of radiation in the bone; or 21 (g) Any combination thereof. 22 4. The holder of a limited license shall not perform 23 procedures using contrast media, mammography, nuclear 24 medicine or radiation therapy. 25 5. As used in this section: 26 (a) “Bone densitometry” means the quantitative assessment of 27 bone mass using single or dual energy X-ray absorptiometry. 28 (b) “Radiography” has the meaning ascribed to it in 29 NRS 457.182. 30 Sec. 38. 1. The Division may issue a license by 31 endorsement to engage in radiation therapy and radiologic 32 imaging or a limited license by endorsement to engage in 33 radiologic imaging in accordance with the provisions of this 34 section to an applicant who meets the requirements set forth in 35 this section. 36 2. An applicant for a license by endorsement or a limited 37 license by endorsement pursuant to this section must submit to the 38 Division an application in the form prescribed by the Division 39 and: 40 (a) Proof satisfactory to the Division that the applicant: 41 (1) If applying for a license to engage in radiation therapy 42 and radiologic imaging, holds a valid and unrestricted license, 43 certificate or other credential to engage in radiation therapy and 44 radiologic imaging issued in any state of the United States, the 45

– 33 –

- *SB130*

District of Columbia, the Commonwealth of Puerto Rico or any 1 other territory or possession of the United States; 2 (2) If applying for a limited license to engage in radiologic 3 imaging, holds a valid and unrestricted license, certificate or other 4 credential to engage in radiologic imaging issued in any state of 5 the United States,